Adverse Childhood Experiences Among American Indian and Alaska Native Adults in California

Alex J. Bates, PhD, MD, MPH, Susan H. Babey, PhD, Nicamer Tolentino, MPH, Antoinette Medina

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Fact Sheet Press Release

Graphic with AIAN access to healthcare, adverse childhood experiences, and suicide publication covers

Highlights

American Indian and Alaska Native (AIAN) adults in California are disproportionately impacted by adverse childhood experiences compared with all California adults and national estimates.

Emotional abuse was the most common type of adverse childhood experience reported by AIAN adults.

For each type of adverse childhood experience cited in the study, rates among AIAN adults were higher than rates among all California adults.

Summary

Published Date: August 27, 2026

American Indian and Alaska Native (AIAN) adults in California reported significantly more adverse childhood experiences (ACEs) than adults overall in the state, based on combined data from the 2021–2024 California Health Interview Survey (CHIS).

Experiencing a higher number of ACEs is associated with progressively worse outcomes, with the highest risk found among individuals exposed to four or more ACEs.

Findings:

4 in 5 AIAN adults (80%) in the state reported experiencing at least one adverse childhood experience, significantly more than the 67% of all California adults who reported the same.
More than 1 in 3 AIAN adults (36%) experienced at least four ACEs, and more than 1 in 5 experienced at least five ACEs (22%), roughly double the rates seen for all adults in California (20% and 11%, respectively).
More than half of AIAN adults in California (53%) reported experiencing emotional abuse, significantly more than all California adults (39%).
All types of ACEs were relatively common: substance use in the household (43%), physical abuse (35%), parental divorce or separation (34%), witnessing intimate partner violence (33%), mental illness in the household (31%), sexual abuse (26%), and incarceration of someone in the household (18%).

Data Points

80%

of American Indian and Alaska Native adults in California reported experiencing at least one adverse childhood experience.

36%

of AIAN adults in California experienced four or more adverse childhood experiences, compared to 20% of all adults.

2.7

Average number of ACEs experienced by American Indian and Alaska Native adults in California, significantly more than the average for all California adults (1.8 ACEs).